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A nurse is teaching a client who was prescribed lisinopril for hypertension. Which statement by the client indicates a need for further teaching?

A patient with chest pain hast BP 78/48mmHg and is pale and diaphoretic. What should the nurse do first ? 

A nurse is assigned to care for four clients. Which client should the nurse assess first?

The nurse assesses a client who has new onset atrial fibrillation. The ventricular rate is 145 beats/min. What does the nurse expect to observe?

The nurse cares for a 22-year-old female with an eating disorderHistory And PhysicalA 22-year-old female was admitted voluntarily to the inpatient unit following a need to ‘get help with her eating habits.’ Reportedly, the client admits to eating a large amount of food and feeling ‘disgusted’ afterward, which triggers self-induced vomiting. She has done this multiple times and reports it has gotten out of control.’ She says she is always worried about her appearance ‘not being good enough.! She denies using any laxatives or diuretics; however, her mother reports she found two empty boxes of laxatives in her apartment.On exam, the client is alert and completely oriented. She is cooperative during the exam and has an anxious and worried affect. She has a slender appearance and a current body mass index (BMI) of 20. Scars were observed on both index fingers. She says physically, her only complaint is daily heartburn and occasional dizziness during exercise. For the nursing diagnosis: Disturbed Body Image , select the appropriate nursing intervention. 

The nurse is performing an admission assessment on a client admitted to the behavioral health unit. The client is reporting new-onset blindness after witnessing a traumatic motor vehicle accident. The nurse suspects that this client is using which defense mechanism?

A client in a psychiatric clinic tells the nurse, “I want to kill my wife. The moment I see her, I am going to kill her.” Which of the following should be the nurse’s next action?

The nurse in the behavioral health clinic is caring for a 48-year-old male client. Nurses’ Notes 1230: Client presents for a follow-up appointment. He reports 100% adherence with prescribed ziprasidone. Two weeks ago, he was prescribed lithium, for which he reports a mild thirst. This thirst is causing him to go to the bathroom more frequently overnight. He reports that he recently got a second job to save for a vacation. On assessment, the client is alert and completely oriented.He had a logical thought process. Lung sounds were clear bilaterally, and peripheral pulses were 2+. Skin is warm, dry, and normal for ethnicity. Rapid eye blinking and persistent chewing motions in his mouth despite not eating any food or gum. He reports that this started two weeks ago. Current weight is 128 kg (282 pounds). Current BMI is 26kg/m2. Previous weight one month ago was 126 kg (277 pounds). The most recent hospitalization was one month ago for a manic episode. Laboratory data reviewed. Diagnostic ResultsCalcium 10.5 mg/dl (9.0-10.5 mg/dL )Chloride 99 mEq/L (98 to 106 mEq/L )Creatinine 0.9 mg/dL (0.6 to 1.2 mg/dl )Potassium 3.8 mEq/L (3.5-5.0 mEq/L )Sodium 137 mEq/L (135 to 145 mEq/L )Blood urea nitrogen 12 mg/dL (10-20 mg/dL )Fasting glucose 202 mg/dL ( 70-110 mg/dL )White blood cell 11,000/mm3 (5,000-10,000/mm3)                                                                                                                              Hematocrit (Hct) 45%    Male: 42%-52%                                                                                                                                                                                                          Female: 37%-47% (0.37-0.47)Lithium level 0.4 mEg/L (0.6-1.2 mEg/L) The nurse is reviewing the initial intake information.Which of the following assessment findings requires immediate follow-up? Select all that apply.

The nurse is presenting at a conference on the management of mental health disorders. Which statement would be appropriate for the nurse to make regarding schizophrenia?

The nurse in the emergency department (ED) is caring for a 19 years male client.  Nursing notes 0210: Client brought to the ED via ambulance. The client was at a party and was ingesting an unknown substance. The client became paranoid, lashing out at other individuals, reported feeling ‘very hot.’ and subsequently collapsed on the ground. 0216: On assessment, the client was hyper-alert, vigilant, and paranoid. “I know you are out to get me!” Not oriented to situation. Pupils were 5mm. Electrocardiogram shows sinus tachycardia with a rate of 126. Peripheral pulses 1+. Lung sounds were clear bilaterally. Abdomen was taut, normoactive bowel sounds in all quadrants. Vital signs: T 103° F (39.7° C), P 126, RR 22, BP156/96, pulse oximetry reading 98% on room air. 0220: Physician notified for orders. 0239: Orders received. 22-gauge intravenous access was obtained in the left forearm. 0300: Vital signs reassessed: T 103° F (39.7° C), P 129, RR 24, BP 160/96, pulse oximetry reading 97% on room air. 0315: Called to the room by the nursing assistant. The client struck the nursing assistant with his closed fist. The client discontinued his IV access. Select the correct option.